柴芍六君汤联合左金丸治疗肝胃郁热型反流性食管炎临床研究

Clinical Study of Chaishao Liujun Tang Combined with Zuojin Pills for Reflux Esophagitis of Depression-heat in Liver and Stomach Type

目的:观察柴芍六君汤联合左金丸治疗肝胃郁热型反流性食管炎的临床疗效,及其对患者血清胃泌素(GAS)、食管黏膜组织中过氧化物酶体增殖物激活受体γ(PPARγ)和缺氧诱导因子-1α(HIF-1α)表达的影响。方法:选取43例肝胃郁热型反流性食管炎患者,随机分为实验组21例与对照组22例。实验组给予柴芍六君汤联合左金丸治疗,对照组给予泮托拉唑肠溶片联合枸橼酸莫沙必利分散片治疗。治疗后比较2组内镜积分和治疗总有效率,观察2组治疗前后血清GAS浓度及食管黏膜组织中PPARγ、HIF-1α表达的变化。结果:治疗后,2组内镜积分均较治疗前降低(P <0.05),实验组内镜积分低于对照组(P <0.05)。对照组总有效率68.18%,实验组总有效率95.24%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组血清GAS水平均较治疗前升高(P <0.05),实验组血清GAS水平高于对照组(P <0.05)。治疗后,2组食管黏膜组织中PPARγ及HIF-1α表达水平均较治疗前降低(P <0.05),实验组PPARγ表达水平低于对照组(P <0.05)。2组HIF-1α表达水平治疗后比较,差异无统计学意义(P> 0.05)。结论:柴芍六君汤联合左金丸治疗肝胃郁热型反流性食管炎疗效确切,其作用机制可能与升高患者体内血清GAS水平,降低PPARγ及HIF-1α表达水平有关。

Objective: To observe the clinical effect of Chaishao Liujun tang combined with Zuojin pills for reflux esophagitis of depression-heat in liver and stomach type and its effect on gastrin(GAS) in serum, the expression of peroxisome proliferator activated receptors γ(PPARγ) and hypoxia-inducible factor-1α(HIF-1α) in esophageal mucosa in patients. Methods: Divided 43 cases of patients with reflux esophagitis of depression-heat in liver and stomach type randomly into the experiment group(n=21) and the control group(n=22). The experiment group was treated with Chaishao Liujun tang combined with Zuojin pills,and the control group was treated with pantoprazole enteric-coated tablets combined with mosapride citrate dispersible tablets. Compared the endoscopic scores and the total effective rate of the treatment in the two groups after treatment,and observed the changes of GAS concentration in serum and the expressions of PPARγ and HIF-1α in esophageal mucosa in the two groups before and after treatment. Results: After treatment, the endoscopic scores in the two groups were lower than those before treatment(P < 0.05);the endoscopic scores in the experiment group were lower than those in the control group(P < 0.05). The total effective rate was 68.18% in the control group and 95.24% in the experiment group,compared the two groups,difference being significant(P < 0.05). After treatment,the GAS levels in serum in the two groups were higher than those before treatment(P < 0.05);the GAS level in serum in the experiment group was higher than that in the control group(P < 0.05). After treatment, the expression levels of PPARγ and HIF-1α of esophageal mucosa in the two groups were lower than those before treatment(P < 0.05);the expression level of PPARγ in the experiment group was lower than that in the control group(P < 0.05). There was no significant difference being found in the comparison of the expression levels of HIF-1α between the two groups(P > 0.05). Conclusion: The application ofChaishao Liujun tang combined with Zuojin pills has obvious curative effect in treating reflux esophagitis of depression-heat in liver and stomach type. Its mechanism may be related to the increase of GAS levels in serum and the decrease of expression levels of PPARγ and HIF-1α.